Association of preoperative EpCAM Circulating Tumor Cells and peripheral Treg cell levels with early recurrence of hepatocellular carcinoma following radical hepatic resection.
Association of preoperative EpCAM Circulating Tumor Cells and peripheral Treg cell levels with early recurrence of hepatocellular carcinoma following radical hepatic resection.
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术前EpCAM循环肿瘤细胞和外周Treg细胞水平与根治性肝切除术后肝细胞癌早期复发的关系
DOI：
10.1186/s12885-016-2526-4
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发表时间：
2016-07-20
期刊：
影响因子：
3.8
通讯作者：
Fan J
中科院分区：
文献类型：
--
作者：
Zhou Y;Wang B;Wu J;Zhang C;Zhou Y;Yang X;Zhou J;Guo W;Fan J
背景本研究旨在确定肝细胞癌（HCC）患者术前外周上皮细胞粘附分子阳性（EpCAM+）循环肿瘤细胞（CTC）和调节性T细胞（Treg）水平对于预测根治性切除术后复发的预后意义。方法总共招募了49名即将接受根治性切除的HCC患者参加该研究。 PCR和FACS检测术前EpCAMmRNA+CTCs和CD4+CD25+Foxp3+Treg细胞的水平。应用Kaplan-Meier法和多变量Cox比例风险模型分析EpCAMmRNA+CTCs、CD4+CD25+Foxp3+Treg细胞等临床病理因素的预后价值。结果EpCAMmRNA+CTCs和Treg/CD4+细胞数作为HCC术后复发的预后因素呈显着相关性：EpCAMmRNA+CTC ≥ 2.22 （P = 0.001）和Treg/CD4+≥ 5.07（P= 0.045），其中EpCAMmRNA+CTC ≥ 2.22（P= 0.003，HR = 6.668）是最重要的指标。 CTC/Treg 水平高的患者术后 HCC 复发的风险显着高于 CTC/Treg 水平低的患者（66.7% vs. 10.3%，P< 0.001）。与低CTC/低Treg水平组相比，高CTC/低Treg组的1年复发率也较高（50.0% vs. 10.3%，P= 0.004）。结论EpCAMmRNA+CTC和Treg/CD4+水平升高与HCC早期复发相关，提示临床预后较差。因此，EpCAMmRNA+CTC 和 Treg/CD4+ 的联合检测可能为 HCC 患者提供新的预后预测因子。
BackgroundThis study was carried out to determine the prognostic significance of preoperative peripheral epithelial cell adhesion molecule- positive (EpCAM+) circulating tumor cell (CTC) and T regulatory (Treg) cell levels in hepatocellular carcinoma (HCC) patients for the prediction of postoperative recurrence following curative resection.MethodsA total of 49 patients about to undergo curative resection for HCC were recruited into the study. PCR and FACS were used to detect the preoperative levels ofEpCAMmRNA+CTCs and CD4+CD25+Foxp3+Treg cells. The prognostic value ofEpCAMmRNA+CTCs, CD4+CD25+Foxp3+Treg cells, and other clinicopathological factors were analyzed by applying the Kaplan–Meier method and the multivariate Cox proportional hazards model.ResultsThe number ofEpCAMmRNA+CTCs and Treg/CD4+cells showed significant correlation as prognostic factors of postoperative HCC recurrence:EpCAMmRNA+CTC ≥ 2.22 (P = 0.001) and Treg/CD4+≥ 5.07 (P= 0.045), withEpCAMmRNA+CTC ≥ 2.22 (P= 0.003, HR = 6.668) being the most important indicator. Patients with high CTC/Treg levels showed a significantly higher risk of developing postoperative HCC recurrence than those with low CTC/Treg levels (66.7 % vs. 10.3 %,P< 0.001). The high CTC/low Treg group also presented higher 1-year recurrence rates compared with the low CTC/low Treg level group (50.0 % vs. 10.3 %,P= 0.004).ConclusionsElevatedEpCAMmRNA+CTC and Treg/CD4+levels were associated with early recurrence of HCC, indicative of poor clinical outcome. The combined detection ofEpCAMmRNA+CTC and Treg/CD4+may therefore provide a novel prognostic predictor for HCC patients.